Abstract
Background: Bendamustine (Ben) and combinations of Ben/rituximab(R) therapies have shown high efficacy in relapsed/refractory indolent B-cell non-Hodgkin lymphoma (NHL) and mantle cell lymphoma (MCL). There are few data including efficacy and toxicity about retreatment with Ben after relapse. Patients and methods: Ten pts (4 follicular lymphoma, 3 other low grade B-cell lymphoma, 3 MCL) who had been previously successfully treated with the first Ben and maintained its efficacy for over 6 months were retreated with Ben between December 2010 and November 2015. The median age was 72 years (56-77) and the sex was 4 males and 6 females. Pts received Ben at 90-120mg/m2 on day 1 and 2 in a 21-28 days cycle for up to 6 cycles. R (375mg/m2) was added on day 1 in 9 pts. Prophylactic acyclovir and trimethoprim-sulfamethoxazole (ST) were used. Granulocyte colony-stimulating factor (G-CSF) was administered in case of severe neutropenia. The median observation duration was 46 months (18-60) from the first treatment and 18 months (2-35) from retreatment. Results: The number of previous regimens was 2 (1-5). An overall response rate was 90% (60% complete response rate (CR) and 30% partial response) by 5 cycles (2-6) of Ben. Those 9 pts previously obtained CR by the first Ben. Another 1 pt who had previously obtained stable disease (SD) by the first Ben got CR by retreatment of Ben. Response duration was 19 months (2-28). 1 Pt obtained CR after 2nd retreatment. Grade 3 or 4 reversible hematologic toxicities were observed. Severe non-hematologic adverse events were not observed. Although cytomegalovirus (CMV) antigenemia was observed in 3 pts, the treatment for CMV was not required. Conclusion: Our data suggests high activity and good tolerance of Ben retreatment (with R) in pts with relapsed/refractory lymphoma despite previous Ben treatment. In this point of view, prospective studies should be considered to establish efficacy and safety of Ben retreatment.
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